HBV Genotypes And Drug Resistance-mutations Of HBV P Gene In Chronic Hepatitis B Patients Of Single Center In Xiamen

Objective: To investigate HBV genotypes and gene mutation patterns of HBV P gene in xiamen region in order that provides impersonal evidence for designing more effective therapeutic strategies.Methods: The serum samples from 60 chronic hepatitis B out-patients in Zhongshan hospital affiliated to Xiamen University during February 2015 to August 2016 were collected to be detected HBV genotypes and gene mutation patterns of HBV P.Determining the genotypes and HBV virus load by quantitative fluorescent PCR;hepatitis B virus markers were tested by enzyme-linked immunosorbent assay(ELISA);Using nested PCR to amplify HBV P gene and the results were analyzed by ABIPRISM Big Dye Sequencing tools and ABI 3730 genetic analyzer.Results:(1)Thirty eight cases were detected as genotype B(accounting for 63.3%)and22 cases were detected as genotype C(accounting for 36.7%)in 60 patients with chronic hepatitis B.Neither B/C mixed genotype nor other genotypes were found.There were no statistically significant differences between B and C genotype in patients with six,age,HBV DNA levels and gene mutation rate(P>0.05).However,the HBe Ag positive rate(71.4%)of genotype B patients was lower than genotype C patients(95.2%),and the difference was statistically significant(P<0.05).(2)The mutation rates of rt M204V/I and rt L180 M were obviously higher than other P gene sites.(3)Twenty cases were detected with resistant mutation,accounting for 33%.Thirteen of these cases(65%)had 1amivudine resistance sites with a majority of witch was rt M204V/I+rt L180 M mutation.Five of these cases(25%)had adefovir resistance sites with a majority of witch was rt A181 or rt N236 T mutation.Eight of these cases(40%)had telbivudine resistance which were accompanied mainly by lamivudine.Only one case was entecavir resistant.There was no patient of tenofovir resistance in this research.(4)There was no significant difference between male and female patients in rt M204V/I or rt L180 M of P area,but the age.(5)rt M204V/I of P gene mutation mostly occured with rt L180 M,rt A181 V and rt N236 T mostly occured alone.Conclusion: The HBV genotype B was the predominant infection in Xiamen followed by genotype C.The main mutation sites are rt M204V/I and rt L180 M in P gene.The resistance to Lamivudine and telbivudine was most commonly observed in the patients of Xiamen.Associated mutation was common in drug-resistant sites of P gene.